Central Administrative Tribunal - Mumbai
Nvs vs Department Of Education on 10 May, 2024
1 OA Nos. 538/2022 & 2087/2019 CENTRAL ADMINISTRATIVE TRIBUNAL, MUMBAI BENCH, MUMBAI. ORIGINAL APPLICATION Nos.538/2022 & 2087/2019 Dated this Cock doy the 1p thday of oe 2024, eo CORAM: Ms. Harvinder Kaur Oberoi, Member (J) (OA No .538/2022 1. Navodaya Vidyalay Samiti NVS Retired Employees Association through its President Shri A.B. Bhardwaj, Office at. E-3-601, Daffodils Society, Pimple Saudagar, Pune -- 410027 having registration No. MAH/1326/2021. 2. Rajesh Kumar Gupta Flat No.4B/502; Kalpataru Estate Phase, 2; Pimple Gurav Pimpri Chinchwad; Pune [email protected]. eae Applicants ( By Advocate Shri R.G. Walia ) VERSUS i. The Union of India through the Secretary, Ministry of Education, Shastri Bhavan, New Delhi ~-- 110 O01. 2. The Commissioner Navodaya Vidyalaya Samiti, B~-15, Sector 62, Institutional Area, Noida ~ 201 309. -.. Respondents (By Advocate Mrs. N.V. Masurkar) 2 OA Nos, 538/2022 & 2087/2019 OA No. 2087/2019 K. Sivaraman son of Late K.G. Nair Aged 61 years, Retired as Asstt. Commissioner (Admn) Navodaya Vidyalaya Samiti, Regional Office, Pune Residing at 4-D-902, Phase-? Kalpataru, Pimple Gaurav, Jawalkar Nagar, Pune - 410 061 Presently at Nagpur. wae Applicant ( By Advocate Shri R.G. Walia ) VERSUS 1. Union of India, Notice through the Secretary, Government of India, Ministry of HRD., Deptt. Of School Education, Shastri Bhavan, New Delhi - 110 OO1. 2. The Commissioner Navodaya Vidyalaya Samiti, B-15, Sector 62, Institutional Area, Noida --- 201 309. _.. Respondents (By Advocate Mrs. N.V. Masurkar) ORDER Per: Ms. Harvinder Kaur Oberoi, Member (J)
These two Original Applications were heard together since a similar question of law is involved 3 OA Nos.538/2022 & 2087/2019 and similar relief has been prayed for.
2. OA No.538/2022 has been filed by the applicant on 11.04.2022 under section 19 of the Administrative Tribunals Act, 1985 seeking the following reliefs:
"(A) direct the. respondents to modify the circular No.25-1/2013-
_ NVS(GA) dated 25.05.2015, which envisaged by extending hospital treatment to the serving employees only by modifying the same that the said circular will be applicable to the retired employees of the respondent No.2 and the medical benefits to be given to the retired employees at par with CGHS/CSMA rates Jrom the empanelled hospitals and to issue fresh circular incorporating the detailed guidelines regarding modalities to be Jollowed by retired employees while availing both indoor and outdoor treatment from various Govt./CGHS/CSMA approved hospitals, with permission to avail casual treatment by the retired employees as per the ceiling fixed by NVS at Rs. 15000/ through the AMA per annum (Annexure No.03) B) That, the respondents may be directed to consider that the CGHS coverage be made available to the retired employees and their dependents of NVS and pass a Proposal for extending CGHS coverage or in alternatively respondents may be directed to comply the minutes of XXXIrd, 55" and 634 meeting of the Finance Committee of the respondent No.2, whereby extending the CGHS coverage to the retired employees of NVS as applicable to the regular employees.
(C) That, the Hon'ble Court be pleased to issue direction to the respondents that the pensioners should be given one time option at the time of their retirement and after retirement for medical coverage under the CGHS Scheme or CS(MA) Rules, 1994.
(D) That, the Hon'ble Tribunal be pleased to quash and set aside the office order No.F:No.13-10/2021-NVS (Admn)/1444 dated 14,12.202] and direct the respondent to take the decision jor extending the medical benefit to the retired employees and to make the reimbursement of the medical expenses (Annexure No. 16) (E) The Hon'ble Tribunal be pleased to direct the respondent No.1 and respondent No.2 to extend medical facilities to the petitioners at par with that of serving employees of respondents in view of provisions of / 4 OA Nos.538/2022 & 2087/2019 Central Services (Medical Attendant) Rules, 1944.
(F) Award any other relief as deemed fit by the Hon'ble Tribunal.
(G) Awarding cost of this application."
3. Applicant in OA No.2087/2019 has filed this OA No.20.03.2019 under section 19 of the Administrative Tribunals Act, 1985 seeking the following reliefs:-
"(A) the Hon'ble Tribunal be pleased to quash and set aside the order dated 22.02.2018, whereby applicant's representation dated 26.05.2017 was rejected by the respondents and held that, retd. Employees are not entitled to get the benefits under the Provision of CS(MA) Rules.
(B} the Hon'ble Tribunal he Pleased to direct the respondent No.1 and respondent no.2 to extend medical facilities to the applicant at Par with that of serving employees of respondents in view of provisions of Central Services (Medical Attendant) Rules, 1944, (C) Award any other relief as deemed fit by the Hon'ble Tribunal.
(D) Awarding cost of this application."
4, The applicant of OA No.2087/2019 had approached the respondents praying for an extension of medical facilities to the retired employees of Navodaya Vidyalaya Samiti in the same manner as applicable to the serving employees of NVS. He had relied upon various court decisions and claimed that a 5 OA Nos, 5338/2022 & 2087/2019 the retired employee of Samiti be extended the same medical facilities as being granted to the serving employees. The Commissioner of NVS i.e. respondent No.2 observed that since NVS had adopted the Central Services (Medical Attendant Rules) for extending medical facilities to its employees, under CS(MA) Rules, retired employees are not entitled to medical benefits. Given the rule position, the applicant's request in OA No.2087/2019 was rejected.
5. The Union/Association, applicants of OA No.538/2022 have made a similar request. On the repeated request of the individuals - retired employees and their Association, the respondents decided to take up this issue in the 54th Meeting of the Finance Committee of Navodaya Vidyalaya Samiti. This demand of the retired employees was considered as item No.5 of the 54t® meeting and the following decision was taken:-
"Item No.5 : PROVIDING OF MEDICAL BENEFITS TO THE RETIRED EMPLOYEES OF NYS.
At present, the Samiti is following the Central Services (Medical Attendance) Rules, 1944 for providing medical facilities to the serving regular employees of the Samiti. Under the Rules, a ceiling of Rs. 15,000/- per annum per employee (including family) has been fixed by the Samiti for Out Patient Treatment taken through Authorized Medical Attendants / approved Hospitals. In addition, reimbursement 6 OA Nos. 538/2022 & 2087/2019 of expenditure incurred on in Patient Treatment taken in hospitals approved under CGHS / CS (MA) Rules is also allowed as per rates notified by the Ministry of Health & Family Welfare from time to time./ The above medical facilities are available only during service period of the employees and no medical benefits are provided to those employees who have retired from service. Employees of NVS are not ....(not legible) Samiti who joined before Ist January 2004 are covered under CPF Rules and are not entitled for any pensionery benefits after retirement.
Accordingly, the Samiti approached to some other organizations for ascertaining the nature of medical facilities provided to their retired employees. The medical benefits provided by various organizations to their retired employees, ascertained by NVS Hgrs., are as under:-
SLNO. | Name of the| Medical facilities being provided to the retired employees Organisation CTSA CTSA is giving the fixed amount of medical allowance @Rs.300/- per month to all its retired employees.
KVS KVS is giving the fixed amount of medical allowance @Rs.300/- per month to all its retired employees.
NCERT NCERT is extending CGHS facilities to its retired employees. 4 NIOS NiOS is extending the medical facilities to its retired employees at par with CGHS under NIOS Society Medical Benefit Rules.
5 CBSE CBSE is extending the medical facilities to its retired employees at par with CGHS under CBSE Medical Policy. 6 JNU Jawahar Lal Nehru University is extending the medical factilities to its retired employees at par with CGHS under JNU Medical Attendance and Treatment Rules.7 OA Nos.538/2022 & 2087/2019
7 UGC UGC is extending the medical facilities to its retired employees at par with CGHS under UGC Medical Benefits Rules, In this regard, it is submitted that Central Government Employees under CGHS are required to pay the following monthly subscription for availing CGHS facilities after retirement;
Grade Pay drawn by the Officer -- Per|Contribution-Per Month Month Up to Rs.1,650/- Rs.50.00 Rs.1,800, Rs.1,900, Rs.2,000, Rs.2,400,|Rs.125/-
Rs.2,800 Rs.4,200/- Rs.225/-
Rs.4,600, Rs.4,800/-, Rs.5,400/- and|Rs.325/-
Rs.6,600/-
Rs.7,600/- and above Rs.500/-
The Samiti may also consider charging the same amount of subscription from those retired employees who opt for claiming medical benefits from the Samiti after retirement. The scheme will thus be optional for the retired / retiring employees of the Samiti.
It is, therefore, proposed to provide medical benefits to the retired employees of NVS as admissible at the time of their retirement, which would also redress a major grievance of the employees who do not have any other post-retirement benefits.
The Finance Committee may kindly consider and approve the above proposal."
6. In the next meeting i.e. 55th meeting of Finance Committee of NVS, again the issue was considered in item No.5, the same is reproduced as under:-
ITEM |AGENDA BRIEF OF DECISION ACTION TAKEN NO. jITEM BY THE SAMITY 5 PROVIDING | After detailed deliberations on the proposal for|The proposal is OF MEDICAL) benefits to retired employees of NVS, the| under process, 8 OA Nos. 538/2022 & 2087/2019 BENEFITS Committee observed that some of the TO __ {comparisons made in the proposal were EMPLOYEES | factually incorrect. Moreover, the proposal did OF NVS not contain the financial implication. The Committee , therefore, desired that the Samiti should either explore the possibility of getting 'Corporate Mediclaim Policy' or workout a Medical Scheme for its retired employees with provisioning of meeting the medical liabilities from a self-substainable fund specially created for this purpose from monthly contribution of the employees while in service an/or lumpsum contribution at the time of retirement, with limited liabilities on NVS/Government,
7. On 29th December, 1993, the following notification was issued "The Executive Committee of the Samiti at its meeting held on 12"
January, 92 had approved adoption of Central Govt. Rules and Regulations in the service matters of the employees of the Samiti mutatis mutandis till such time the Samiti framed its own rules and regulations. The above decision of the Executive Committee had been notified to all concerned vide No.F'6-1/92-NVS (Admn.) dated 30" March, 1992."
Thus it was submitted that once the Samiti had approved adoption of Central Govt Rules in service matters, then the medical benefits/facilities available to the employees serving or retired should be extended. However, in breach of the executive committee's decision to adopt central govt rules, the CS(MA) rules have been adopted.
9 OA Nos.538/2022 & 2087/2019&. Counsel for the applicants submitted that this agenda was also taken up before the Executive Committee which is larger and above the Finance Committee. In the XXXIV meeting held on 27.06.2016, the following decision was taken:
"XI The CGHS coverage is not available to the employees of NVS. Accordingly, MHRD in consultation with Commissioner, NVS will draw a proposal for extending CGHS coverage to all the employees of NVS."
9. A brief report on the activities of the Committee was submitted and this proposal was approved. It is pertinent to mention that the Chairman of the Executive Committee is the Minister of Human Research Development. Learned counsel therefore submitted that once the agenda was approved in the Executive Committee meeting by the highest authority in NVS i.e. the Executive Committee, there is no reason why the medical facilities as claimed by the retired employees of NVS be not extended to the retired employees.
10. Learned counsel for the applicants has also relied upon OM issued by the Ministry of Health dated 29th September, 2016. The relevant paras 3 & 4 are reproduced as under:
10 OA Nos.538/2022 & 2087/2019"3, In view of the above, reimbursement of medical claims to Pensioners under CS (MA) Rules, 1944 as directed by various CATs/Courts, need not be referred to the Ministry of Health and Family Welfare. The respective Administrative Department /Ministry may take their own decision in this regard.
4. Further, all Departments/Ministries are 'requested to intimate their employees Proceeding for retirement regarding the above options for medical facilities available to the Central Government Pensioners,"
ii. Mrs. N.V. Masurkar, learned counsel for the respondents submitted that the respondents are aware of the difficulties faced by their retired employees. However, they are bound by the CS(MA) Rules which have been adopted by them. The rules itself do not provide any medical facilities to the retired employees. As per Note Z(iv) of Rule 2 of the CS (MA) Rules, 1944, it has been Clearly outlined that retired Central Government employees do not come under the purview of the said Rules and that they are not eligible for medical reimbursement. She submitted that the retired employees which is the Association and other individuals have been forwarding their request for extension of medical facilities to them.
il OA Nos.538/2022 & 2087/2019
12. Given the above and till the scheme is formulated, the respondents have issued a circular dated 25.05.2015, whereby a list of hospitals/laboratories that are willing to provide medical treatment to NVS retired and = serving employees on CGHS rates has been provided. She submitted that it is due to the efforts of the respondents that the hospitals could be approached and made to agree to provide the medical facilities to the retired employees on the discounted CGHS rates. However, the bills would not be reimbursable as the respondents do not have any scheme to provide any medical facilities to the retired employees. It is admitted position that the issue of providing this medical facility to retired employees was taken up on many occasions before the Finance committee as well as the Executive committee. However, the approved agenda could not be implemented due to the huge financial burden that would have to be borne by the NVS, if medical facilities were extended to retired employees, 12 OA Nos. 538/2022 & 2087/2019
13. Learned counsel for the applicant has relied upon the decision of the Chandigarh Bench of the Tribunal wherein a Similar issue was under
consideration, in the case Of Dharminder Sharma Vs. UOr, M/o. Health and Family Welfare, New Delhi, OA No.737/2015 & 29 Ors.
dated 07" May, 2018. Relevant Paras are quoted herein under:
"25. At the first instance, the CS(MA) Rules, 1944, provided medical reimbursement to the employees. Even Notification dated 5.61998 also posits that the CS(MA) Rules, 1944 would apply to the retired employees as well. Thus, the denial of claim of the applicants is arbitrary, illegal and hit by articles 14 and 16 of the Constitution of India. Moreover, CS(MA) Rules, 1944 and OM dated 5.6.1998 read with clarification of 2004 and argument raised by learned counsel for the respondents, were duly considered and negatived by this Tribunal in a bunch of OAs decided on 22.1.2016 along with main OA No.060/00884/2014 titled BALDEV SINGH SON OF LATE SH. AVTAR SING VS. UNION OF INDIA & OTHERS, relying upon decision in PARTAP SING VS. DIRECTOR, SUBSIDIARY INTELLIGENCE BUREAU, 2007 (2) SLJ 185 (CAT) - Principal Bench, New Delhi and other judgments mentioned therein, wherein it was held that if a right has accrued to the pensioner, by virtue of notification dated 05.06.1998, for reimbursement of medical expensés incurred, it cannot be taken away by a clarificatory memorandum. Above all, an administrative order/OM cannot over turn the indicated judicial -- pronouncements. Similarly, in the case of R.JAMBUKESWARAN ¥. UNION OF INDIA, 2004 (2) ATJ, CAT 1, it was observed that the decision of the Government and CS(MA) Rules, 1944, to the extent of denying the reimbursement of the medical expenses to the retired employees are not reasonable.
26. Not only that, the import and applicability of the CS(MA) Rules, 1944 and clarification dated 20.08.2004 were re-examined, which were held to be arbitrary and illegal, by the Hon'ble Punjab and Haryana High Court in a bunch of Writ Petitions, decided along with main Writ Petition No.26270 of 2015 titled UNION OF INDIA AND OTHERS VS. MOHANLAL GUPTA & OTHERS, 2018(1) SCT. 686. ERE ED, HAO ANLAL GUPIA & OTHERS 13 OA Nos.538/2022 & 2087/2019
27. Therefore, once it is held by the Hon''ble High Court, that pointed OM and the rules are illegal and arbitrary, in that eventuality, the right of reimbursement of medical claim of retired employees/pensioners, cannot be denied to them in any manner in the grade of Note 2 of CS(MA) Rules, 1944 and clarification dated 20.08.2004. It is not a matter of dispute that the serving employees are entitled to the medical reimbursement under CS(MA) Rules, 1944, then this right, indeed, cannot be denied to the retired employees, on the basis of equality under Articles 14 and 16 of the Constitution of India, in view of the law laid down by Hon'ble Apex Court in the case of RAJENDRA YADAV VS. STATE OF M.P_ AND OTHERS, 2013 (2) AISLJ, 120, wherein, it was observed that the concept of equality as enshrined in Article 14 of the Constitution of India embraces the entire realm of State action. It would extend to an individual as well, when he is discriminated against in the matter of exercise of right. Equal is to be treated equally even in the matter of executive or administrative action. As a matter of fact, the Doctrine of equality is now turned as a synonym of fairness in the concept of justice and stands as the most accepted methodology of government action. It was also held that the administrative action should be just on the test of 'fair and play' and | reasonableness.
28. _ This is not the end of the matter. It is not a matter of dispute that BALDEV SINGH SON OF LATE SHRI AVTAR SINGH & OTHER similarly situated retirees/pensioners, had filed different Oas(060/00884/2014 etc), on the similar grounds, as have been raised by the applicants in the instant cases. The respondents have taken almost all the similar objections of non-applicability of CS(MA) Rules, 1944 etc. to deny the claim of the applicants (therein). After considering the various judgments and the CS(MA) Rules, 1944 and other OMs, it was held by a co-ordinate Bench of this Tribunal, vide order dated 25.2.2016, as under:- .
33. In the backdrop of aforesaid discussion, we have no hesitation in our mind in holding that right to health is integral to the right to life and the Government cannot escape from its responsibility to provide health facilities to retired employees as well as held by our jurisdictional high courts. Even if one has not become member of the CGHS due to his/her residing in a non-CGHS area, he/she would be entitled to reimbursement of the medical expenses. As has rightly been held by the co- ordinate Bench of this Tribunal at Delhi in the case of Partap Singh (supra) and other cases that the instructions dated 20.8.2004 do not take away the effect of instructions/policy decision dated 5.6.1998, The retirees had to per force opt for fixed medical allowance as the area where they are residing is 14 OA Nos.538/2022 & 2087/2019 admittedly not covered by the CGHS facilities. The fixed medical allowance opted for by the retired employees and given to them is for outdoor facilities only and cannot take care of hospitalization. In view of these facts, these nine Original Applications are allowed. The orders rejecting the medical reimbursement claim of the applicants are quashed and set aside. The respondents are directed to consider and reimburse the medical reimbursement claim of the applicants at the rates fixed by AIIMS/PGIMER, within a period of two months from the date of receipt of a certified copy of this order."
29. Admittedly, the judgment of this Tribunal has already attained finality as the Writ Petitions No.26270 of 2015 (O&M) etc. titled UNION OF INDIA & OTHERS VS. MOHAN LAL GUPTA & ANOTHER ETC. have already been dismissed vide orders dated 17.1.2018 by a Division Bench of the Hon'ble Punjab and Haryana High Court, wherein while rejecting the objections of non-applicability of CS (MA) Rules, 1944 to indicated categories, raised by the Union of india, the Hon'ble Court granted the reimbursement of medical expenditure to the retirees / pensioners. 30, The matter does not rest there. The Hon'ble Punjab and Haryana High Court in the case of AROUDHIA PRASAD DUGGAL VS. CAT, CHANDIGARH & OTHERS, CWP No. 22833 of 2015, decided on 20.2.2017, has ruled as under:-
"We are therefore, inclined to concur with the decision of the Delhi High Court in a substantially identical matter being 'Daljit Singh Versus Govt. of N.C.T. Of Delhi & Ors. WP (C) No.16651/2006 in which, relying upon an earlier decision in the case of 'State of Punjab & Ors. us. Mohan Lal Jindal 2001(9) SCC 217 wherein the stand of the Government in refusing to reimburse the in-patient charges for the treatment in the said Hospital was rejected and the Government was held to be under a constitutional obligation to reimburse the expenses since the right to health is an integral to the right of life, it was observed-
"14. The undisputed position that emerges is that a patient is entitled to reimbursement of the full amount of medical expenses and not only at the rates specified in the circular of 1996 and in case respondent No. 2 has charged a higher rate, than could have been charged, it is for respondent No. 1 to settle the matter with respondent No. 2. The petitioner cannot be deprived of the reimbursement....15 OA Nos. 538/2022 & 2087/2019
4. In view of the above it is no longer res integra that merely because the Government does not revise the package deal amount under the Medical Attendance Rules from time to time a person cannot be denied actual medical costs, and there has to be reimbursement of the actual medical expenses incurred."
31. Meaning thereby, to have a good treatment from a Good Specialty Hospital is a step in aid, to live with dignity, which is a fundamental right of a person guaranteed by Constitution of India. Any such contrary instructions, clarification of 2004 or the redundant rules, framed before the enforcement of Constitution, having the effect of non-reimbursement of medical expenses to the retirees/pensioners are illegal, in-operative, and deserve to be ignored, on the analogy as contemplated under Article 13 of the Constitution of India, 32 There is yet another aspect of the matter, which can be viewed entirely from a different angle. The question, as to whether the retirees / pensioners are entitled for reimbursement of medical expenditure or not, is no more res-integra and is now well settled.
33. An identical question recently came to be decided by the Hon'ble Apex Court in the case of SHIVA KANT JHA VS. UNION OF INDIA, Writ Petition (Civil) No.694 of 2015 decided on 13.04.2018, wherein having interpreted the CGHS Scheme vis-a-vis CS(MA) Rules, 1944, it was specifically ruled as under:-
. 13) It is a settled legal position that the Government
- employee during his life time or after his retirement is entitled to get the benefit of the medical facilities and no fetters can be placed on his rights, It is acceptable to common sense, that ultimate decision as to how a patient should be treated vests only with the Doctor. who is well versed and expert both on academic qualification and experience gained. Very little scope is left to the patient or his relative to decide as to the manner in which the ailment should be treated Speciality Hospitals are established for treatment of specified ailments and services of Doctors specialized in a discipline are availed by patients only to ensure proper, required and safe treatment. Can it be said that taking treatment in Speciality Hospital by itself would deprive a person to claim reimbursement solely on the ground that the said Hospital is not included in the Government Order. The right to medical claim cannot be denied merely because the name of the hospital is not included in the Government Order. The real test must be the factum of treatment Before any 16 OA Nos.538/2022 & 2087/2019 medical claim is honoured, the authorities are bound to ensure as to whether the claimant had actually taken treatment and the Jactum of treatment is supported by records duly certified by Doctors/Hospitals concerned. Once, it is established, the claim cannot be denied on technical grounds. Clearly, in the present case, by taking a very inhuman approach, the officials of the CGHS have denied the grant of medical reimbursement in full to the petitioner forcing him to approach this Court.
14) This is hardly a satisfactory state of affairs. The relevant authorities are required to be more responsive and cannot in a mechanical manner deprive an employee of his legitimate reimbursement. The Central Government Health Scheme (CGHS) was propounded with a purpose of providing health facility scheme to the central government employees so that they are not left without medical care after retirement. It was in furtherance of the object of a welfare State, which must provide for such medical care that the scheme was brought in force. In the facts of the present case, it cannot be denied that the writ petitioner was admitted in the above said hospitals in emergency conditions. Moreover, the law does not require that prior permission has to be taken in such situation where the survival of the person is the prime consideration. The doctors did his operation and had implanted CRT-D device and have done so as one essential and timely. Though it is the claim of the respondent-State that the rates were exorbitant whereas the rates charged for such facility shall be only at the CGHS rates and that too after following a proper procedure given in the Circulars issued on time to time by the concerned Ministry, it also cannot be denied that the petitioner was taken to hospital under emergency conditions for survival of his life which requirement was above the sanctions and treatment in empanelled hospitals.
15) In the present view of the matter. we are of the considered opinion that the CGHS is responsible for taking care of healthcare needs and well being of the central government employees and pensioners. In the facts and circumstances of the case, we are of opinion that the treatment of the petitioner in non-empanelled hospital was genuine because there was no option left with him at the relevant time. We, therefore, direct the respondent-State to pay the balance amount of Rs.
4,99, 555/- to the writ petitioner, We also make it clear that the 17 OA Nos. 538/2022 & 2087/2019 said decision is confined to this case only,
16) Further, with regard to the slow and tardy pace of disposal of MRC by the CGHS in case of pensioner beneficiaries and the unnecessary harassment meted out to pensioners who are senior citizens, affecting them mentally, physically and financially, we are of the opinion that all such claims shall be attended by a Secretary level High Powered Committee in the concerned Ministry which shall meet every month for quick disposal of such cases. We, hereby, direct the concerned Ministry to device a Committee for grievance redressal of the retired pensioners consisting of Special Directorate General, Directorate General, 2 (two) Additional Directors and I (one) Specialist in the field which shall ensure timely and hassle free disposal of the claims within a period of 7 (seven) days. We further direct the concerned Ministry to take steps to form the Committee as expeditiously as possible. Further, the above exercise would be futile if the delay occasioned at the very initial stage, i.e., after submitting the relevant claim papers to the CMO-I/C, therefore, we are of the opinion that there shail be a time frame for finalization and disbursement of the claim amounts of pensioners. In this view, we are of the opinion that after submitting the relevant papers for claim by a pensioner. the same shall be reimbursed within a period of 1 (one) month.
17) In view of the foregoing discussion, we dispose of the petition filed by the writ petitioner with the above terms."
34. Therefore, it is held that the applicants, who are retirees / pensioners, are indeed also entitled to reimbursement of medical claims of the amounts spent on their treatment and any redundant rule or instructions, or impugned order having the effect of denial of such reimbursement of medical claims to them, are arbitrary, illegal inoperative and hit by the Constitutional provisions. As such the contrary arguments of the learned counsel for the respondents, stricto sensu, deserve to be and are hereby repelled, under the present set of circumstances. On the other end, the ratio of law laid down by Hon'ble Apex Court in the indicated judgments, mutatis mutandis, is applicable to the present controversy and is the complete answer to the problem in hand.
35. No other point, worth consideration, has either been urged or pressed by the learned counsel for the parties.
18 OA Nos.538/2022 & 2087/201936. In the light of the aforesaid prismatic reasons, the instant OAs are accepted. The impugned orders (in all the cases) are, accordingly, hereby set aside. As a consequences thereof, the respective competent authorities are directed to verify and reimburse the amount of medical claim of the applicants, within a period of one month, in the same terms and manner, as directed by the Hon'ble Apex Court in Shiva Kant Jha's case (supra). However, the parties are left to bear their own costs."
14, Learned counsel also relied upon the.
judgment in the case of R.S&. Giti Assistant (Retd Vs. Union of India Through The Secretary), Central Administrative rribunal, Principal Bench, New Delhi, OA_No.1549/2013 dated 23.04.2014. Relevant para 9 is quoted below for ready reference:
"14. We in the above facts and circumstances are of the considered view that when the employees of KVS have already been availing the CGHS facility while they were in service, they cannot be left in lurch after they retire without Providing them an alternate scheme for the protection of their health, Right to health is an essential part of right to life guaranteed under Article 21 of the Constitution. We, therefore, allow this OA and quash and set aside the impugned order dated 08.10.2012. Consequently, we direct the Respondent- KVS and the Respondents-Director General, Central Government Health Scheme (CGHS) and the Min. of Health & Family Welfare to work out the necessary modalities as in the case of other autonomous bodies whose retired employees have been granted the facilities of the CGHS Scheme. The same facilities shall be extended to the Applicant and all other retired employees of KVS who opt for the same. Necessary instructions in this regard shail be issued by the Respondent-Union of India within a period of 3 months from the date of receipt of a copy of this order. There shall be no order as to costs."19 OA Nos. 538/2022 & 2087/2019
15. I have considered the rival submissions and the documents on record. To my mind, this is not an adversarial litigation. Respondents are aware of the issue and have attempted to get it resolved. The minutes of the meetings of the executive and the Finance committee show that respondents were exploring various possibilities to formulate a scheme to grant medical facilities to retired employees. On one occasion, the highest executive committee of NVS had approved the agenda to extend medical facilities to retired employees also. On the part of the applicants, they are willing to contribute and subscribe to the CGHS scheme as per the rules.
16, In view of the law as laid down in Shiva kant Jha (supra) and orders passed by the co-ordinate benches referred to above in detail, the Original Applications are disposed of with a direction to respondents to implement their own approved agenda and to implement the same, work out the modalities and formulate the scheme and rules to extend CGHS scheme to the retired employees. This exercise be done by the respondents within 4 months from the date 20 OA Nos.538/2022 & 2087/2019 of receipt of a certified copy of this order.
Pending MAs, if any, stand closed. No costs, (Harviridér 'Kaur Oberoi) Meniber (J) ma.
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